In Iowa, training requirements for personal care aides (PCAs) are uniform—but minimal compared to training requirements for home health aides and nursing assistants. Since 2006, Iowa’s long-term care leaders have been striving to create a competency-based training and certification system that spans all direct care workers and ensures high-quality care across populations and settings. While their efforts have achieved promising results, actual training requirements have not been adopted by the state. This report is part of a three-part series focusing on states that have led the way in developing PCA training standards.